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tv   Key Capitol Hill Hearings  CSPAN  November 6, 2013 12:00pm-2:01pm EST

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in particular how the false promises are affecting real people. in this case, my constituents. he said i received notice last week that my health care will more than triple. currently i am paying $265 a month for me and my two young sons. on january 1, my premium will be $836 a missouri the president promised you can keep your plan and families will save every year. i can keep my plan i just can't afford it. i qualify for subsidies $80 a month. while there was a promise families were going to save money with this, clearly not the case for this family. there is a promise that's been eluded to. the president and others said if
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you like your insurance, you can keep it. a woman sent me an e-mail and it's short. i'll quote it. she says i'm a two time breast cancer survivor and i'm facing the loss of insurance as of march 1, 2014. president obama said we would be able to keep our insurance if we liked it. that was untrue. >> third promise if you like your doctor, you can keep your doctor. i got an e-mail on october 7 from a woman and i'll quote, she said i've been self-employed for 1 years and have never been without health iven assurance. three years ago i was diagnosed with multiple scle loss sis. having a preexisting condition was not a problem for me as i had never let my insurance lafments my medication cost would be $4,000 per month without insurance. i received notice they were going to cancel my plan and i
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had to sign up for new coverage through the health insurance exchange. if my coverage is not in place before january 1 i will have to go without my medications. this will cause permanent disabilities, blindness and problems walking. any plan i find that would cover me channels me back to signing up through the exchange. i'm a small business owner and a productive member of society. i own my own house. now 50eu78 in trouble. we call this woman and we discuss this. it turned out there were two options available to her through the exchange. one option would allow her to continue to see the doctors that have been treating her. the other option would cover the medication, negotiate option would cover both. these an elk dotes -- well it's clear to me they've been repeated many times, i think millions of times across the country. and it's a hugte problem. so i guess my question for you
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is i understand this administration is never going to want to repeal this bill. i get that. i understand you've delayed whole sections of it but don't want to delay the individual mandate for instance. my question is there r there any changes you want to recommend we could make to this bill so that the promises that were made by the president, by yourself, by others for these people, promises which clearly are not being kept could actually in fact be kept? are there any that you would recommend to us? >> senator, i'd be happy to work with members of congress who want to achieve the goals of the bill which are to provide for the first time affordable health coverage for millions of people who don't have it and an additional goal of the bill i in the is to
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marketplace, the last remaining market where people have been denied coverage because about a quarter of the people who seek insurance can't get it at all, medically underwritten, denied because of preexisting condition where they have an opportunity to move forward. if there is some framework that is you have in mind, what i really want to do is get the program up and running and get information to people about how they can take advantage of -- >> the program as it's designed, the bill as it's designed does not honor these promises. let me ask the grandfathering clause we all know has so many exceptions that many plans are simply not grandfathered. are you willing to reexamine the exceptions to the grandfathering clause so that many plans could be actually grandfathered? > i don't think grandfathering
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perspectively can work very well since companies are now in the market with an array of new plans. many have added consumer protections in the last three and a half years. as you said, the regulation came out shortly after the bill was written. it provided a framework. we've been working with insurers as they look to what plans they would put in the new marketplace, what plans they would keep in place. and the grandfather clause has been part of that ongoing discussion. >> we're going to have to move on. thank you very much. >> thank you mr. chairman. i know you've probably seen lots of headlines. i don't know if you've seen this one, thousands face delay in healthcare enrollment. over 100,000 workers will be able to sign up as of october 1. the reason why i'm asking you about that particular headline is because it's from the boston globe august 3, 2006.
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and in that case, we do know the rest of the story. the rest of the story is that the governor of massachusetts estimated that only 123 consumers signed up in the first month but eventually tens of thousands did and now today the state has nearly universal coverage. they went from one in four ople having insurance to uninsured being one in four to 2340u being one in ten. we know the results so to me it's a reminder of what our goal was which is to address double digit increases in insurance rates were preventing people from getting insurance coverage. so to me the issues of the website and software since it's part of a background i've had
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before, to me it's about writing code and getting things tested and it's very frustrating for sure. in my mind it nowhere resembles something like the blowout preventers failing and oil gushing into the gulf and us struggling for months and months to get a scientific way to clean up that resource. in this case it's about just getting the code right and making it work and function. in that case, governor romney asked for and got a three-month delay. i know the chairman asked you to comment on that. i think there is no shame in pushing out a date based on technology. that's my opinion. and i want to note that washington state's own experience has been more positive. one of the issues that was cited in our local press was this
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issue of not having people have to sign up to enter the site to get data. as they call at this time amazon model and i'd like to get your comments about that. and then i want to get your comments too about this issue of this individual market and cancellations. one 2004 report said in the individual market only 17% of people keep their plans on an annual basis. so obviously there is a huge amount of churn that goes on in that individual market. maybe we don't have a number or answer today, but it would be great to get that daltta and if we have to get it from insurers we should have a number about what that annual churn rate has been the last decade because my sense is we are probably following that pretty closely today. some are saying the end all
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be all problem with this we need to have a better understanding, so if you have any way to shed light on those two issues? >> i would say with the discussion of the individual market, the data again that continues to be cite sd our projection of what would happen with the affordable care act is a look back at the market. somewhere between 40% and 60% of people turn over on a regular basis. contracts for insurance are one year so it is not unusual to not have the same policy or practice a year later. they are not a continuous work benefit. the individuals who are in the market want to get insurance. they don't have a workplace insurance. they are not medicare eligible. they are not a veteran. they want insurance and often struggle with not only price
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increases at about 16% a year where the average. but everybody is medically underwritten so that any illness, disease, could block you from the market in the first place or put you in a pool that could skyrocket and lock oust. the protection that is the affordable care act added to the individual market, the last market without consumer protections are the very one that is every worker in a small group plan enjoy or in a work site enjoy. you can't be locked out because of a preexisting condition. you must be offered a policy. nur a risk pool so your own disease profile doesn't determine your rates. that is what is happening with that market. more than 50% of the people are not in their policies for a year. a third are there for only six months. it is a very volatile, very expensive, very unprotected marketplace for way too many folks.
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i have watched you today and watched you being eviss rated over in the house, calls for your resignation, nod your head but your resignation have emanated from this distinguished panel and it all makes me want to just say some things. number one, i attach some importance to the fact that this bill which was crafted, a lot of it in the finances committee, a lot of it out open understand public, that when it came to the floor, there was not one single republican who voted for the plan. this was two years ago, maybe a little bit more. and i ask myself how could that be possible. senator isaac son was asking about rural georgia as i would
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ask about rural west virginia. last saturday i was at a rural health center in a very isolateded part of west virginia. and it just cazzly occurred to me there is about $10 billion in the bill to create new rural health centers all across america. does anybody know that? i don't think in west virginia and i don't think generally. and i'm stunned by the prospect of let's say 100 million people being uninsured or underinsured that the president makes a couple of statements that perhaps he shouldn't have made and then that become it is whole argument. all the letters i was promised this, i was promised that. and i'm trying to think of all the benefits that come from this. i work very closely with the chairman and others on this bill
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in the finances committee to produce it. and i think it's a magnificent work. my people in west virginia don't necessarily share that view right now because i think they have the problem that so many others have that they simply don't know what is in the bill nd because of the absolutely admiral republican attack machine, including all the television. this has to be the worst thing that ever happened to america. and then i look at the bill and i said this -- we're the only country that doesn't do something like this and we've done it very well. people are going to get insurance and the underinsured are going to get insurance. it's 80% of consumers change their plans every two years, you indicated it might be a little bit more than that. the republicans are talking
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about provider shock saying people won't be able to keep their doctors, an argument which in many cases is almost comical and so farfetched when you consider it's designed to help people who did not have health insurance and almost by definition did not have any regular primary care physician. but taking every single possible dark attack, taking two statements, taking the website which is frustrating to all of us, but if there is anything that can be worked out it's the web sifmente it's a technology matter and that will happen. i'm not for delaying unless they can't fix it in time which in that case i think a penalty should be lifted. but i'm incredibly proud of the bill and i'm incredibly proud of
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you and marlin going before committees and getting eviss rated but standing your ground and knowing exactly what you've done far more than most of us. and certainly far more than most of those who are viciously making a political attack. that's risen in the last five years along with the tea party and with the coke brothers and the rest of it. and you can really sour people on multiple television ads. . 's not that hard to do i want your resignation, hand it in today. those things are so unrelated to the tragedy of underinsured or uninsured americans which this bill sets out to successfully over a period of years actually solve their problems. people never talk about tax
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credits, small business they keep saying they are december separate about it and the fact 30% ofmatter is they get their tax credit of the premium paid by tax credit on the first year and then after that 50% on a permanent basis and you never hear that. this is not so much a question but a statement of sadness about the ability of the upper body, the cooling body with the cup and the saucer and that sort of outine that we can be so political that we just seek to destroy and forget the agony that people are going through which this bill will cure. >> thank you very much. > welcome, thank you for
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joining us today. others, my colleagues have shared with us headlines they've noticed recently or in the past as they relate to implementing healthcare changes. i just want to add to that. i asked my staff to dig up some headlines as well. and they d. one was early f. another is not led i did for prime time. another was confusion rains. a fourth was doctors and pharmacists say some will die. as you might guess those weren't headlines from this month or last month. those were from six or seven years ago when you were implementing medicare part d which i voted for. it was a perfect know. we had problems. a lot of people fell into the huge donut whole. they didn't get any help from medicare and a lot of people got
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sick and went to the hospital and it cost a lot of money. with the affordable care affect we went back and fixed a problem . we fixed a problem that was in place created by the original proposal which i supported. we're hearing a lot of la meant about folks who there are a million people who apparently are not going to be able to continue with their insurance policy. maybe it's a substandard problem. as we try to help those folks, let's keep in mind a lot of people in this country call our offices and have policies that aren't worth the paper they are written on and we need to be concerned about those. e need to be concerned about the young people who today would not have any health insurance because they aged out and today
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they have coverage. i'd have us keep them in mind as well. i'd have us keep in mind the millions of people over the years who have actually lost coverage, they lost it pauf preexisting condition. they lost it at a time they needed it most. as we work to address the concerns by a couple of million people who aren't going to be able to keep the policies they want and are facing large increases in premium that's a problem. we need to fix that. the other thing we need to put in perspective is this, over in japan they spend half what we do on healthcare. they get better results. they cover everybody. last night when people went to bed in this country 40 million people went to bed without coverage at all and we're trying to do something about it. in the tend republicans weren't able to work with us.
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it was sad. chairman bachus cried hard enough. in the end the legislation signed by the president, they are republican ideas. some good stuff from the republicans came in and found their way into the law. one of those is large purchasing pools, we call them exchanges. i think it was a republican idea . it was taken and tried to incorporate it and make it work. it's a good idea. the idea of the individual mandate, that's as i recall that's a heritage foundation idea that governor romney embraced as part of the law in massachusetts. let me looking forward we've had ten hearings just before the implementation of law, since the
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implementation of law on october 1. i think when we were doing this six or setch years ago, i think we had two hearings, one was four months after the program was implemented and we decided back then not to harass people. we just let them do it and then bring in hearings after the fact. that's what we need to do. can you report to us today on the progress what improvements have the american seen within the last morks what can we see in the next several weeks? >> well, senator, i think i'm the first to admit that the rollout has been excruciatingly awful for too many people. a lot of people couldn't get in the site in the first place. and then when they were able to access the site, screens would go down all the time.
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they couldn't get from place to place. i would say those are the two primary areas of fock cuss and era of n a continuous improvement with a rigorous schedule of improvements we are adding hardware and software to fix the function nalt and increase the speed and make sure we are able to handle the volume of people who want to use and access the site on a regular basis. so there have been significant improvements. we are not satisfied at all where we are now. we are committed to an end of november experience that is significantly had better on volume and speed and reliance and making sure we get to people. and we have a very specific plan to go back and reinvite people back to the sites who started at
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one point along the way and may have been so frustrated they gave up. we don't want to do that until we are sure their experience will be significantly better than it was the first time. we know that a lot of young folks have little patients with any technology that doesn't work instanceously. that audience is particularly important to get a very highly functional site up and running and that's what we're doing. >> now turning to the most patient member of this committee. >> thank you mr. chairman. thank you for being here. yesterday administrator tab ner testified on the security testing for which was broken down into testing for the hub and for the federally facilitated marketplace system. she testified there had been no end to end testing on the marketplace.
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she approved a september 27 memo that to move forward with issuing the authority to operate . the memo specifically noted this and i'd like to quote it. quote from a security perspective the aspects of the system that were not tested exposed a level of uncertainty that can be deemed a high risk. were you aware of that memo? >> i was made aware of it recently. i did not know that the memo existed in september. >> how many times did you and administrator tab ner talk about the security aspects and specifically this decision to move forward with the authority to operate? >> we did not discuss the authority to operate. >> did you at any point notify the white house of the security concerns that existed about the exchange? >> i would say that there were
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conversations, senator, about risks in terms of getting the system up and running but i was not aware of this and i did not have these discussions with the white house because i was not aware of them. >> did the white house know there had been no end to end testing on the security aspects of the exchange? >> i think the white house was aware of the operation issues involving end to end testing and i don't know the specifics of -- again, i did not have the discussions about this authority to operate issue with the white house. >> you testified last week in the house that it was the law that made you stand up the exchange on october 1. in fact, the statute as i read it requires enrollment to start. it does not require the exchange to stand up. were you given different legal advice within hhs in >> senator, what the law says is
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that benefits started on january 1. the law also said that the secretary shall designate by regulation a date of open enrollment and that that regulation needed to be promulgated by june of 2013. >> correct. but that did not require to you stand up the website. it required you to open enrollment. >> open enrollment yes and a significant portion of open enrollment was the website. >> if administrator tab ner will h not done the authority to operate, if she had not signed it, the exchange would not have stood up on october 1, correct? >> that's correct. but it was done specifically she had advice from her senior i.t. and operations team as well as the contractors >> so it wasn't the statute that made the website stand up on
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october 1, was it? >> open enrollment began and a significant part of open enrollment was the website. administrator tab ner testified enrollment was approximately 800,000. i know your plans are to release that update. do we have your assurance you ll break that down
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>> we are working on the problem. we plan to return to live demonch just a moment here on
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c-span. >> while we work to fix the issue we'll show you testimony with kathleen sebelius. >> mr. chairman, i'm relying on the advice of not only the inside team and contractors but a lot of the outside experts who have come in to take a look at the system and they did a number of things along the way. they did a series of diagnostics, looked at the entire system and determined at the out set that is fixable, that it isn't fatally flawed which was the initial report out of many people. secondly we have asked that question a number of times,
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would it be helpful to take the whole system down and make mixes along the way? we've been adviced that actually doesn't help. that it is better to do routine upgrades, some of which are hot patches that can be done while the system is fully run rninging, others are better to be done in the maintenance period between 1:00 a.m. and 5:00 a.m. when the user experience is pretty low and we take the system down for periods of time. but given the fact that the various fixes, particularly the function nalt fixes, the codes have to be written in batches, it's been advised that you don't gain much from just taking the whole system down for a week or a couple of weeks. it's better to do that -- >> remarks from earlier today before the senate finances committee. and now back to live testimony
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on capitol hill. >> analysis of 49 states and found that on average premiums in the individual market of increased by 41% under obama care and in my state of north carolina the manhattan institutest mates that the average increase is 136% higher under the affordable care act. i thank the chair. >> thank you. i think a couple of senators would like a couple more questions. >> i won't keep you very long madam secretary. did i misconstrue, you said you felt there would not be a lot of people sign up between now and the beginning of the next year? >> no, sir, i said the enrollment numbers we will release next week are likely to be low given the strug thals people have had getting access
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to the site and information. >> do you expect the numbers to be very high during the month of november and december? >> i'm hoping that with the site improvement we'll see more robust numbers but until the site is fully improved and we open up the doors wide to a lot of people, we're going to have i think a struggle getting significant numbers to sign up. >> i'm not trying to put you on the spot. but it comes back to my original concern, why is it so difficult to put this off until we have it up and running, running right with the right kind of security so that people's personal and private information isn't stoubt fraud and these fraudsters that naturally come into this system because we're not prepared? >> again senator, i would say ha the site has met the highest
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standards of security for federal government sites. we have taken great care again not to store personal identify bli information in the hub. goinge met the testing is on 24/7 as each piece of software is added. we need to continue to test the site and that's part of why we have a temporary authority to operate and not a permanent one because until all the pieces of the system are installed and you can do toned end testing at the very end but that won't be for a while. so the mitigation strategies are in place. it's ongoing and daily and we take privacy and security of the american public very seriously. >> don't they have to give their personal information, social security number, their income, elts and isn't that put into the system? >> when they hit the hub,
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senator, that is actually referred back to data bases and social security in homeland security and i.r.s. the federal marketplace will retain application information. >> don't they have to give that kind of information now? >> for the application, yes. >> that's what i'm worried about. if we don't watch this and if we don't have a fail safe system and you admit you don't have a third party testing unit in there trying to make sure this works. >> we do have third party testing. >> who is that? >> miter is the third party tester. it tested prior to going live in october. they did sign off ongoing live in october. they are continuing to test. we have a security team who is monitoring and performing weekly
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testing of border devices, conducting daily scans of the monitoring tools and they will conduct a full security test in a stable environment when the entire site is loaded. but we don't have the spanish website up yet. that's an additional piece coming. the shop website is coming. you can't do the end to end testing until the entire system is stood up. >> that again makes my case that we shouldn't be getting into this until it's all set up. it would be better and safer and more protective of people's rights and of their personal information. i guess what i'm saying is i think you do need an independent testing agency that isn't a hired contractor to do this. but i just want to raise these issues. i know this is very difficult for you and i appreciate you
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testifying here today. i hope you will answer our letters when we send them to you because i've had letters out to you that i never got any answers on. we're not anytime to just give you a rough time. we're in it to try and hopefully get it right. >> i would love to work with you to get it right. >> thank you. >> that's the main point of this whole hearing is to get it right. and you just heard the ranking member of the committee saying he wants to work with you to get it right. i mentioned in my opening statement that i and i'm speaking for the majority of this committee want to help you get it right. but it's a two way street. you have to tell us what is working and what is not working. american people need transparency. the more you don't tell us the
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greater the problem is going to be. the more you do tell us, the good, the bad the more likely we'll get this right at an earlier date. don't wait until the end of october to tell us we're not going to be up and running end of november. work with us. this is the law. we want to do this right. there are many points in the law that are so meritorious. growth of duce the healthcare cost in this country. in addition to efforts by private entities to control cost, we're making headway. one senator mentioned that japanese healthcare cost are 8%, administrative cost are 7%, u.s.
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18%. we have to work to get that down. we want to keep working with you . why? because that's our job. we represent americans. we represent people all across this country and they want this to work. they don't like the politics in this town. they just want the thing to work so let's work together to make it work. >> i would welcome that. thank you. >> just one comment. actually there is another party that has to have the attitude mr. chairman that you do and that is the republican party in the senate and the house and the republican national committee and all of those people that are doing everything they can to destroy you, the president and there are speculations as to what molt vation for that might be. they have to cooperate.
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in other words, what the chairman is saying is that we will do everything we can. and he did everything he possibly could and was unable to on the floor of the senate get a single republican vote for the bill. it's a far reaching quite extraordinary bill. and i just want to add they have responsibility to help as opposed to simply criticize. >> i think this is a terrible bill. and that's not because i'm a republican or a democrat. i've worked as much on healthcare issues around here in the last 37 years as any number of people. and frankly better than most. i have a desire to have things
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work. but let me tell you, senator reid i think said it very well. he said is this going to work and he basically said that it's just a step on the way to a single payer system meaning a one size fits all federal government run system. that's what worries republicans and i think it worries good democrats too. and i'm very concerned about this going into a socialized medicine situation where we really really can't control the cost, continue control the system and we dent grate the system instead of helping it. so naturally i'm concerned about it and a lot of republicans are concerned about it and i even know some democrats who are concerned about it. this is not a simple bunch of political acts working at it. his is a very serious set of problems. i don't envy you to be in your
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position and have to answer all these questions and have to be the front person in trying to make this thing work. all i can say is that i'll try to help make it work if i can. but i don't think it's going to work and that's the problem. and without costing america an arm and a leg and without really taking people's health care away from them. but i think there are sincere people on both sides who would like to solve our healthcare problems in this country and the president said 85% of america had health insurance they were satisfied with. why didn't we just work on etting the 15% to have the healthcare they need rather than jeopardize the whole system and to have all these problems that aren't going away quickly and may never go away? >> thank you very much.
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let's remind all of us to keep our eye on the ball. and the ball we're keeping our eye on is get this thing working. given the level of interest i just want to indicate the senators will have a week to get their questions in madam secretary to you and i urge you to respond immediately to those questions so we can keep moving ahead. thank you very much. he hearing is adjourned.
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>> secretary southeast bell youse wrapping up her testimony. as we've done a number of times after these hearings we'd like to hear from you by phone or twitter. you see the numbers on your creen. > secretary sebelius testifying. let's get to your calls. we go to west virginia first up this. is barbara on the independents line. caller:, hello. i would like to say that a lot
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of people with west virginia are loser their insurance coverage. my husband and i -- he's retired military and we were forced off of our good coverage plan. not only is all the other people losing their coverage. we had a good plan and we had to downgrade to pay more. we pay $3,000 more each person deductible now thaven we ever had to pay before plus more on our prescriptions. >> this was all a result of the implementation of the healthcare law? caller: yes. they said we had to get off that plan by october 1 of this year. host: was it your understanding that once the law came into effect you would have been able to keep the plan that you liked there? caller: yes. that was told on the t.v. but
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you know when this law first passed in 2010 i believe, at the they started then. you have to switch. you have to switch. and i said no, i want to keep the good plan. they said you either switch now or you're going to be forced in october 2013. host: is the plan have you now by the same provider of the plan you had before? caller: yes. host: but it's costing you more? caller: i don't know about that. yes, it is costing us more. we have to pay $3,000 we never had to before each individual. and plus we have to pay more for prescriptions which we didn't have to before. host: let's go to on the democrats line. small i help run a software company for about six
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years. and we had to change our plan probably once every year for the four years. new doctors, new plan, premiums would double. and actually this happened in the 90's until now affordable care act or cost and changes were rising and that is why the affordable care act has been put into place. to w this go on from 1993 1997 and our cost went from $85,000 in 1993 and the next year they wanted $150,000 and
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the next year they wanted to go $250,000 and we were 60 employees and they would double each year. each year we had to go out to id and change plans. they all were changing. they are all influx. at the end of the day the criticism to this is the same we ould have heard in 1965 with medicare or 1936 with social security. up until -- for almost 20 years republicans were obsessed and obstructive with social security. they stood in the way of medicare and they are standing in the way of obama care and the affordable care act. host: that's ken in more of your calls coming up on c-span. the hearing just wrapped up. kathleen sebelius. the chairman asked her why not
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just take the website down. here is what she had to say. >> why not shut down and do it right? >> well, mr. chairman, i'm relying on the advice of not only the inside team and contractors but a lot of the outside experts who have come in to take a look at the system and they did a number of things along the way. they did a series of diagnostics, looked athe entire system and determined at the outset that is fixable. that it isn't fatally flawed which was the initial report out of many people. secondly, we have asked that question a number of times wouldn't it just be helpful to take the whole system down and make fixes along the way? we've been advised that doesn't help. that it is better to do routine
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upgrades, some of which are hot patch which is can be done while the system is fully running. others are better to be done in the maintenance period between 1:00 a.m. and 5:00 a.m. when the user experience is pretty low and we actually take the system down for periods of time. but given the fact that the particularly the functionity fixes, the codes have to be written in batches, it's been advised that you don't gain much taking the whole system down for a week or couple of weeks, it's better to do this on an ongoing basis. >> jeff said he has a punch list and they are going to punch them out one by one. how many ofite rms there on that punch list and which have been
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punched out and when do you expect them all to be punched out and when do you expect to do the end to end testing after they are punched out? >> jeff has come in to help manage the operations between the contractors and the c.m.s. team and the aggressive fix schedule. he'll be with us hopefully through this process and he has been enormously helpful in being a management lieutenant with maryland the c.m.s. administrator. i would say there are a couple of hundred functional fixes that have been identified and they are in priority grouping. the first series of them have been under way. we're making -- and it depends on the night. it's hard to give you a moment
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by moment snapshot. there were a number that were done last night, hardware additional installations were done over the weekend. at 5:00 or 6:00 each day it's identified whether or not the testing for the individual coding fix can be actually applied that night so the list changes. but we will get you an update and i would say we are into the list. we're not where we need to be. it's a pretty aggressive schedule to get to the entire punch list by the end of november. >> are you going to do it end to end after you go through the couple hundred items on the purge list? >> because the site is running it is end to end daily. people are coming in and going through the system every day and that helps identify some of what we are seeing so we are actually doing with live time end to end testing that then can go back
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and inform the tech team what else needs to happen. >> i want this to work. i want to do what i can to help make it work. but that's a two way street. have you to tell us what is going on fully so we don't wake up end of november low and ehold still not there yet. >> continuing with your calls and comments on the hearing on your experience with the affordable care act. let's hear from chris who is a republican in florida. caller: how are we doing? host: fine, thanks. caller: this is all since 2010. i was working at a predominant restaurant and liked working there. i was there for six and a half years. they made a big change to reduce most employees that were working less than 32 hours.
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we were full time employees. they shoved us down under 30 and made us part time which changed our health coverage. just recently it started getting more expensive and that was across the board. the company changed so much i went to another restaurant and pursued a career as a cook. i haven't qualified enough hours to get their healthcare. i got that letter. following that letter within 48 hours i got another letter stating to get health insurance through the marketplace. the website was crashing during that time. just recently as of monday morning at 10:00 a.m. i've been laid off from that job where i was a full time employee. they knocked me down down to part time and now they are only keeping supervisors and three full time employees at this location here. >> host: and this is a restaurant chain in panama city?
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caller: yes in panama city beach. i worked at two of them. i worked for one man at another restaurant. had great repor with him. now because of all this i'm scrammling to figure out my bills and get unemployment and food stamps. food stamps has changed here in florida. also in florida their website and their system to get on to unemployment has had several glitches which have been referred to in the miami her raled on one of their blog sites it's having the same problems as obama care. host: which is your priorityty now, unemployment or healthcare? caller: unemployment and apply through medicare because i don't have any income to afford anything through the exchanges. host: we go to denver on the
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independent line. caller: one comment is i've watched these hearings with kathleen sebelius and her number one person, i have to say it's pretty embarrassing to watch these things. virtually no one asks real questions. there are some that do and i'm glad they are. most are preprepared talking points on both sides or attacks and it's pretty disgusting to watch. if the american people saw more of this i think they would be frustrated. host: what would you ask? caller: there are two main questions, one came up today and that is the security issue of this system. there is vast amounts of personal data in this and if they aren't testing this and if this thing is not secure and information is broken into and
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sfolen, we're going to have the supreme mess. the second something i don't think anyone really knows what their premiums are going to be since you can't access it or so few can, we don't know if people's premiums and including their out of pocket expenses are really going up or down. and this is frustrating for me as an owner of a c.p.a. firm and i work with the government all the time for people not to know what they are really paying. host: appreciate your call. let's get a couple of comments on twitter. it's a mischaracterization to imply that most individual mayor medical plans that don't meet aca are inferior. candy says you didn't like the
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amendment it is republicans offered and they were very good and would have made the bill better. and one more says they all work for us and yet we can't fire them. north carolina democratic line. go ahead. caller: for years i've been bat tling state a and in himin caller: way you and and forcing me to pay for care when i didn't need it and they saying it wase across the board. either at the state level or the federal level, you are forcing me to buy something that i do not need and will not use. why should i have to pay for it? and ezekiel emanuel set -- kept saying that this was going to have cost shifting, but it is not. it is shifting the cost of the elderly care to the younger generation. it is shifting the crop -- the
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cost of prenatal care to men who are young and not married. whether you like it or not, those are the facts. host: president obama will be back out on the road talking about the health care law. he is in dallas today. we will have his comments at 5:40 p.m. eastern here on c- span. joining us from west lafayette, indiana, hi, joan. your radio ormute television and go ahead with your comments. work for a major large insurance company and when i , we were given our health plan that has been on for years and retirees were allowed to stay on. but then after obamacare was passed, we were notified that we would no longer be able to stay with our company. and it is our assumption that because of obamacare and their thinking that this would affect us, we were then directed to go
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out and secure our own insurance . this is what i'm afraid a lot of the large companies in the next year are going to probably see , that they're going to have to put their employees into these exchanges. when you work those long years, you expect to have the benefit of the promise, but it is unfortunate to have it end. i hope politicians can get together and agree to do something to stabilize this. it is affecting all of us, whether we are retired, working, or not working. one more here. this is jean in new york city on the independent line. for- caller: thank you taking my call. the two-party system is not working. to spend 600 billion dollars and
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not have a system work is embarrassing. of publicly traded companies are announcing layoffs. this plan will take food from people's tables. we will have a number of defaults on mortgages again. we will have a number of layoffs , even much larger because you have private companies that we cannot see the number of people being laid off. .e will have reduced time people are going from a 40, 50 hour work week to a 30 and 20 hour workweek. spendingking consumer off the table. this plan is going to bankrupt this country. thank you for taking my call. thank you for your call. we will have more later. you can weigh in on twitter. next up, though, i want to remind you that we will show you the hearing from today, the senate finance committee hearing with kathleen sibelius tonight at 8:00 eastern here on c-span. up next, the director of the center for maryland -- medicare
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services, marilyn tavener. we covered this yesterday as well. onthe standing committee health and labor and pensions will please come to order. about five years ago, richard
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a 47-year-old truck driver from eugene, oregon was frustrated and worried. as the columnist nicholas times" in the "new york described this weekend, he could not find insurance in the market. back in the battle days, no insurance company would cover him. he just went without care. after it months of ignoring pain, he finally went in for a colonoscopy. but he could not afford one. the only way he could get it is from a doctor who agreed to take half payment now and have payment later whenever he could afford it. after driving 100 miles to get the results, he felt -- found out he had advanced: cancer. cancer.ed colon his doctor said this. i am very angry with people who insist that obamacare is a train wreck when the real pain wreck -- train wreck is what people
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are clear and thing everyday because of the care they cannot afford. mr. streeter is the second patient that dr. has been this has putause of -- who off care because of a lack of health insurance. he has a long road ahead of him, but now he will not have to worry about how to pay for his treatment. he signed up for health insurance during january 1, which cannot now turn him down because of his pre-existing condition. we passed the affordable care act so that this would never happen to another family. right now, millions of americans are shopping on new health insurance market places for coverage that starts next year. 700,000 people have filed applications. and why is there this surge and interest? because for the first time in history, their health, whether or not they have a chronic illness or an allergy or had a back operation 10 years ago, will not prevent them from getting insurance.
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these reforms will finally deliver on the long-overdue promise to all americans -- if you work hard and play by the rules and pay your fair share, you will never have to stay awake at night worried that you cannot afford to see a doctor or pay your medical bills. it is a promise i wish we could have kept sooner for mr. streeter. a status will hear report of the implementation of these reforms. as everyone knows, the rollout of the federal -- of the federal health insurance marketplace has been bumpy, to put it mildly. consumers have run into roadblocks, the site has been functional one day and unresponsive the next. americans waiting for years for this moment deserve better. the president, the secretary sebelius, and our witness today have taken full response ability for the technical flaws of the website and said that no resource will be spared to fix it. i look forward to an update today on those efforts.
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i share my republican colleagues concerns about the websites technical flaws and the bumpy rollout, and i look forward to a discussion about how we can move forward. clear.ant to be very i hope we are here for a constructive discussion, not a game of gotcha. i am as upset as anyone at the individuals who want to apply for coverage on the federal marketplace experience, and i want to learn how those problems will be fixed. but herein may be the difference, i want it fixed. so the affordable care act will -- not -- will succeed be torn down. are many who spent the last three years doing nothing but trying to tear this law down. quite frankly, i feel they have fixed -- they have surrendered their right to express indication -- indignation that
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it is not working flawlessly. we have voted 32 times on repealing or defunding the law. chairman of the appropriations committee that funds the implementation of this law, my republican colleagues year after year have denied implementation at every turn, ,rying to stop navigators sending letters to the national football league warning them not to reach out to the fans. casesicans, who in most run on strong states rights, handed over the responsibility to the federal government. before we get into the details, i think everyone should take a deep breath. this is, after all, a website. this is a machine that will be fixed. americans have until the end of march next year to sign up. said, thesident
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promise of the affordable care act is far more than just a website. the promise of the formal care act is a benefit to the 105 million americans who have been protected against lifetime benefits since 2010. it is a benefit to more than 3 -- three million young people who can stay on their parents policies until age 26. it is a benefit to 7 million seniors who have already saved a billion dollars on discounts on prescription drugs. it is a benefit to the 71 billion people -- 71 million who have missed out on preventive services, which mr. streeter could have used had this law been in effect. it is a benefit to the 129 million not eligible americans with pre-existing conditions who beginning the -- beginning january 1 can no longer be denied or discriminated against by health insurance companies. that is the big picture, and we
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should not forget it. health reform is the promise of the financial security that it brings. in iowa, the marketplace premiums are among the 10 lowest nationwide. a family of four making $50,000 will be able to get bronze level coverage for $103 a month. a 27-year-old making $25,000 will be able to get a plan for less than $100 a month. that is real choice, real affordability. let's get the website fixed as fast as possible so that every american can shop easily and enroll smoothly. let's not forget the big picture. obamacare if you want to call it that, or the affordable care act, millions of americans will not be in the same situation as mr. streeter found himself. that is what it is about. slowly but surely, americans who
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get avoided coverage can coverage for the first time. we owe them to move the ball forward. i will be listening closely when questions are asked of our witness, is this an order to help and fix the system so we can move forward to make this affordable care act work? or is it another means to try to tear down and discourage participation. witness, ms.nk our atener, for her leadership the centers for medicare and medicaid services, and for her leadership to making -- and her dedication to making sure that this works for all. i know we will have questions. that is fine, because i do want to know why this problem came up. but i want to keep the big picture in mind as to what we are really doing here, and that is, to make the system work.
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i finally have one administrative matter. i request that the records remain open for 10 days. now i turn to the ranking member. was in president bush's cabinet -- >> when i was in president bush's cabinet i used to think that the senators deliberately put the chairs down low so that we could be of high. we welcome you. my late friend alex haley would tell a story rather than making a speech. 16,000 have insurance through cover 10, a low-cost narrow coverage state program. (-- obamacare is canceling their policies. what 10 is an example of president obama calls bad apples, an insurance plan that washington decides is not good i recently heard
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from one of those people whose policy will be canceled january 1. she has lupus and she told me she cannot keep her current plan because it does not meet the standards of coverage. this alone is a travesty, she said. it has been a lifeline.
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with the discontinuation, i am being forced to purchase a plan to the exchange. i premiums alone will increase 410%. i out-of-pocket expense will increase by more than $6,000 a year, including subsidies. please help me understand how this is affordable, says emily. i were health care system makes up nearly 20% of our economy, touching the lives of every american. obamacare is pushing that 20% of our economy in the wrong direction. the president has said repeatedly, i looked up the white house website this morning, "if you like your plan, you can keep it and you do not have to change due to the health-care law." that is the white house website today. as the president said, it is a law transforming our health care delivery system in the wrong direction -- it is more than a website, as the president said. it is a law transforming our health care delivery system in the wrong direction, we believe, by increasing premiums, canceling plans, strong relationships with doctors, raising taxes, forcing people into medicaid, spending $.5 trillion on new programs instead of making medicare solvent and encouraging employers to reduce their employees catch three hours. then having the irs fine americans for failing to sign up on a website that does not work. the president promised you can keep your health care, but the plan cancels millions of individual policies.
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for millions of others, employers are dropping insurance programs. the new promise is, if you want health care, go find it. on a website that the administration says will not be working properly until the end of november, that is an unwelcome christmas present. two weeks to shop for insurance by december 15 so that you are covered next year when obamacare outlaws your policy. ms. tavenner, the president put secretary sebelius in charge of this law. i have called on her to resign. before the internet, rca could tell you every day how many records elvis was selling, mcdonald's could tell you how many hamburgers were sold. congressman issa posted notes where you are telling each other how many people are enrolling in obamacare, why won't you tell the american people?
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one senator has described this law as an approaching train wreck. my grandfather was a railroad engineer and kansas. he drove the locomotive and headed it into the right direction, that is what our country needs to do. turn the law around and head it in the right direction. obamacare is the wrong direction, it expands a delivery system that we already knew costs too much.
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the right direction is more choices, more competition that lowers cost so americans can afford to buy insurance. don't expect republicans to show up with our version of a 3000 page bill to move the delivery system in the direction we wanted to go. we do not believe in that approach. we believe in moving step by step in the right direction. make medicare solvent, reform medicare advantaged to compete with medicare. make medicaid flexible. encourage employee wellness plans, small business plans, expand health savings accounts, change 30 hour work weeks to 40 hours. the tennessee woman i told you about, emily, losing her insurance because obamacare has decided it is not good enough for her, she finished her story with these words. "this is one of the biggest betrayals our government has committed on its citizens. i beg you to fight for those like me. we only asked to continue to have what we already enjoy, a fair health insurance plan at a fair price." please find a way to return to affordable health care. my message to emily is that we will do our best to turn this train around and headed our delivery system in the right direction so you can buy and keep health care that you can afford.
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>> on behalf of the committee, i welcome our witness, marilyn tavenner, administrator for center for medicare and medicaid services. she was confirmed by the senate in 2011. she was principal administrator for cms and served for four years as tim kaine's secretary of health and human services in virginia. ms. tavenner spent 25 years working for the hospital corporation of america and began her career as a nurse in richmond. she holds a bachelors of science degree in nursing and a masters in health administration from the virginia commonwealth university. i know you are very busy these days, thank you for coming here to share your experience and answer questions today. ms. tavenner, i would like to -- this is an intricate subject, we
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usually give the witness five minutes. i would like to give you up to 10 minutes to make your opening statement, then we have our questions. welcome, your statement will be made a part of the record in its entirety. please proceed. >> thank you, chairman harkin, ranking member alexander, and members of the committee. on october 1, we launched one of the key provisions of the affordable care act, the marketplace where people without health insurance, including those who could not afford health insurance and those who were not part of a group plan, could get health care coverage. we know that some consumers are having difficulties enrolling via the market place website, and we are focused on identifying and solving those problems quickly. it is important to remember that the affordable care act is more than just a website. it has created a new market which allows people access to
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quality, affordable health insurance options. it does this by pooling consumers into statewide group plans that spread risk between sick people and healthy people, young and old, and then bargains on their behalf for the best deal on health insurance. by creating competition, insurers have created new plants with more choices. the premiums for coverage are lower than expected, billions of americans will also qualify for tax credits to make this coverage more affordable. people will have comprehensive coverage that cannot be taken away, even if they get sick. we know that consumers are eager to purchase this coverage. i want to show you that can and will be fixed quickly, we are working literally around the clock. we have made progress in improving the website, we expect
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the user experience to continue to improve. over the past month, millions of americans have visited to look at their new health coverage options under the affordable care act. in that time, nearly 700,000 applications have been submitted from across the nation. more than half in the federal marketplace alone. this tremendous interest confirms that the american people are looking for quality, affordable health care coverage. we know that the initial consumer experience on has been very frustrating for many americans. some have had trouble creating accounts and logging into the site, others have received confusing messages or had to wait for slow-paced loads or forms that fail to respond. in the first few days that we went live, few consumers could create an account.
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we have now resolved that issue. users can create an account and go through the enrollment process. we are able to process nearly 17,000 registrants per hour with almost no errors. we have updated the site several times, we have added more capacity and doubled number of servers to meet demand. we reconfigured various system components to improve responsiveness, this has increased performance across the site, but in particular the viewing and filtering of health plans during the shopping experience. this now responds in just seconds, whereas it was taking minutes before. we have resolved issues at the eligibility notices display at the end of the process. consumers can compare plants
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without registering for an account, this was not working well in the days leading up to october 1, so we prioritize work on the application process and stead. -- instead. one of our highest priorities was insuring that consumer information was transmitted correctly. our team has worked with issuers to resolve outstanding issues and all necessary consumer information will be sent to issuers after they have enrolled in the plan of the choice. we will work closely with issuers to identify and solve problems quickly. we have also seen success in improving response time. for the first few weeks, we estimate that users are waiting 8 seconds for pages to load. we have lower that time to less than one second, we will take aggressive steps to bring response times down further. we are pleased with these improvements and parts of the system that are already working well.
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the data hub, the routing told that provides an efficient way to verify information submitted by consumers is sending determination to the marketplace and less than 1.2 seconds. the social security administration has reported 4.2 million transactions with the hub, the irs has responded to one point three billion -- million requests. consumers can trust that the information they are providing is protected and that the technology underlying the process has been tested and is secure. cms has decades of experience at collecting personal information in medicare, we are extending that commitment for the marketplace. any system that is this large is inherently risky. we monitor the security of the system as envisioned in the plan and have no serious issues.
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security testing never ends for any large system. we continue to improve, it is important to remember that the website is working, more people are applying and is rolling each week. in addition to the website, there are other ways for consumers to approach one is, they can apply by phone on a toll-free number. a representative will work with a consumer to make sure they can complete the process. people can find in person help in their community to help them understand their options. consumers can fill out a paper application and mail it in, they will find out whether they are eligible for private insurance, medicaid, or chip, then they can go online or contact the call
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center if they prefer. more than three out of every four americans get insurance from an employer, from medicare, medicaid, or the va system. americans who purchase on their own buy coverage on the individual market. before the aca, coverage was unaffordable, had high co-pays, or lacked basic benefits like maternity care, mental health, and prescription drug coverage. these plans had high turnover rates and were often not renewed at the end of the year. the health-care law is creating protections for people in the individual market, as well as strengthening employer-based coverage. in the health insurance marketplace, consumers will not be charged more because of their
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gender or pre-existing condition. preventative services will be covered at no additional out-of- pocket costs, there will be caps on out-of-pocket cost, plans will have to offer 10 essential benefits. plans in place before the affordable care act past and have not been changed are grandfathered in and exempt from consumer protections. they must notify their role enrollees that they are grandfathered. for these enrollees, nothing has to change. individuals have received indications from companies that their plans will no longer exist. this constitute five percent of the population. they can choose a different plan being offered by their insurer or they can shop for coverage in the market is or outside the marketplace.
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insurance companies are not dropping consumers, they are improving options, often offering better value plants with additional benefits. the majority of people and the individual market today will qualify for discounted or free health care coverage and signing up for coverage to the marketplace. one study found that not counting the one million who qualify for medicaid, 48% of people who buy insurance through the individual market will have a tax credit that averages over $5,500. the aca is over four years old, we have seen improvements. medicare, medicaid, medicare advantage. the opening of the marketplace on october one is the latest step in the implementation of the law, we acknowledge that we have a lot more to do and are ready to do it. thank you, mr. chairman. >> thank you, commissioner tavenner. we will start a series of five- minute questions.
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i will hold myself and everyone else to five minutes. you might only get one question, that way we can go around once, twice, three times, as long as it takes so people can get questions asked. i hope we will keep within five minutes so everyone gets to ask questions. we'll start now. ms. tavenner, as we evaluate the problems with the website, it is important to get the facts straight. some have said that fixing the website could take six months to one year, others state that there are 5 million lines of code to rewrite, others urge you to start from scratch. bring some facts to this overheated debate. i understand this can get technical, i want to give you an opportunity to explain in plain english. what is the plan for fixing the website, who is leading, and what is your role?
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what is the expected timetable for the process? >> let me start with the plan, as you all are aware, we engaged qssi as the general contractor. they were engaged last week. they will be leading the effort, working with me directly. they will be responsible for coordinating contracts. the problems are into categories.o the first problem had to do with performance and speed. we have added capacity and made system performance improvements, that has to do with the hardware side of the equation. that work was done immediately. we have projected demand for the website, we obviously underestimated that demand. we had to go back and catch up and at capacity and improve -- and add additional capacity
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and improve performance. that is some of what i was referring to in my comment about the slowness of the system. the second issue has to do with software improvements. the first big one was the ability to establish an e-mail account. that was a problem that was solved in the first week. we have had success there, there is not a problem with establishing an e-mail account or going on to identity proof. now we are into the internal piece of the architecture. i will remind you that this website is covering 34 states and 50 medicaid programs, also services the state raised -- the state-based exchanges. it is pretty complicated. we knew we would have bugs in the system. we obviously have more bugs, particularly around the application.
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we are doing series of software upgrades seven times a week, we will continue that. you will see improvement week by week. this is weeks, not months, we are not rewriting the architecture. >> could you address yourself to the issue of security echo there were several reports that there were issues about the security of the site leading up to october 1. what efforts are we making to ensure that consumer information is secure. >> let me try to take the security question in a couple of different buckets, because i think there has been a lot of confusion around security. over of all, any hearings the summer, a lot of the questions had to do with the security of the hub. the contractor there is q ssi.
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only theerves not federal market place, but all the states as well. it has been a smooth operating system. that security, including testing, was completed by september and there was sign off on the hub. when it comes to the actual exchange, there was security testing by component, and then we did a short term authorization to operate, because we knew we would be making software enhancements we had announced -- that we had announced prior to october 1. we had announced that we would not be bringing this website up right away. a temporary or short term authorization to operate. we knew we would have to do continuous security testing while the programs are being installed and while software was being upgraded. which is routine. i think there is confusion about
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what was tested and what was not tested. i need to separate those. >> i only have 27 seconds. someone be assured that their security -- social security number, for example, no one will be able to hack in and get that? notes, and the hub does store any information. it is a router. when you go in and fill out an irs,cation, it pings the to validate the information and your citizenship. that was part of the identity proofing on the front and that was complicated, because we have taken additional steps to make sure that an individual application was secure. we also have continuous monitoring of all systems, which is something we do for medicare as well. >> thank you. senator alexander. >> ms. tavener, --
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tavener, let me go back to the president's words. i'm sure you will be able to fix .he website and i'm not as concerned about the irs finds that will come next year. concerned about are the canceled policies and the inability of people to have time after you presumably fixed the website at the end of november to replace their policies by january 1 so they will actually have health insurance. and i'm concerned about the kind of health insurance they get, because of a large number of cancellation letters that are coming into our office from tennessee. let me suggest that a way to fix problem of canceled policies in the visual market is to go to a website that does work pretty well. it still says, if you like your plan, you can keep it, and you don't have to change a thing due to the health care law. that is the white house website.
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those were the president's words in 2009. why don't we put those words into law? why don't we solve the problem of emily, the lady i read about from tennessee, who is losing tennesseege, her insurance. and finding it will cost 410% more. senator ron johnson has introduced a bill that he calls, if you like your health care plan, you can keep it. it would basically put the president's words into law. and assure those millions of americans like emily that they a plan like to keep that, and she will not be able on-- be out of insurance april 1. we are talking millions of americans. is, with theo you administration support senator johnson's bill, which would put the president's words into law by saying to americans that if you had a plan before the law was passed on march 23, 20 10,
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or even a plan all the way up to the end of this year, that you can keep it. solve a lot of problems and reassure many americans that they can have affordable health care? wesenator alexander, when wrote the regulation back in 2010, that is exactly what we did, we grandfathered in existing plans, both in the employer market and in the individual market. there was a lot of back and forth about that regulation. that is why we delayed it until basically, plans could be .randfathered and also, we allow the grandfathering to continue as long as it did not reduce benefits significantly. there were some things put in place. i do think we put in steps, the ability to keep plans. now in the cancellation letters, these cancellation letters are also followed by a statement in
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each of them that says -- >> ms. tavener, i want to give you a chance to answer, but will you support senator johnson's bill? thatave not even look senator johnson's bill. i'm happy to look at anything. >> i will get a copy to you. we know about the regulations that will -- were written in 2010. ity effectively made impossible to grandfather a lot of the plans that people had. and according to your own regulations, it was estimated that ordered percent up to 60% would not be able to be grandfathered because of what you put in the regulations. in effect, didn't you know in 2010 that there would be a big turnover of these individual policies and that it was wrong to go across the country saying, if you like your plan you can keep it without having to change a thing? >> i don't think that having the regulation -- i think that the regulation assumed that because of the grandfathering these plans would change. the plans routinely change.
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they are often run -- not renewed. they move about this market. that is what the formal care act is designed to do, to stabilize the market and give the individual protection. >> but your regulations increased cost sharing, co-pays, change the employer, -- employer contribution, all of those did not continue. basically, what washington is saying to those, like a 16,000 who lose their covered plan, we know better than you do. we want you to buy a better plan even though you like what you have and want to keep. why not put the president's words into law and simply say, we will not decide for you. if you like a plan you have, you can keep it without having to change a thing? websitewhat is on the for the white house today. >> for those individuals that you mentioned, they were also given the option of renewing
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those plans. and yes, some of those plans might have been more expensive. i will encourage them to go on the website and take a look at what is available in the individual market in tennessee. i think you will see that the pricing actually came in about 18% lower. also, some of these individuals may qualify for a subsidy. i would encourage them to look at their current issuer, but also to go on the website and take a look at the plans available in tennessee and also to check to see if they qualify for a subsidy. >> thank you, mr. chairman. >> senator mikulski. >> good morning, administrator tavener. i'm glad to see you and i hope you are doing well. we are very proud of the fact that cms is headquartered in maryland. there are thousands of people who work there every day and in every way are trying to make sure that medicare, medicaid, and obama care is delivered effectively and efficiently.
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have beenh you revenue starved, and kind of battered around in the failure to confirm permanent and ministers. -- permanent administrators. but we will put this aside for this conversation. because the launching of the affordable care act has been more than bumpy. i believe there has been a crisis of confidence created in this functional nature of the website, the canceling of policies, and sticker shock from some people. in my own state of maryland it was also bumpy. i read in the baltimore sun this morning that 73,000 marylander'' policies will be canceled. there has been fear, doubt, and the crisis of confidence. let me get to where i am, because it is not to finger point, but to pinpoint. that there is such a crisis of confidence that people will not enroll, and the very people we need to enroll, particularly our young people,
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to make this whole system work will not happen. as you know, the people who are the most desperate, senator alexander's compelling story of thing thate kind of shows serious health problems. old looking at the 24-year- working at startup -- at who is com startup healthy. how are we going to get young people back to looking at how , to makegoing to apply it attractive, to give them confidence in the system, and also to make the whole system more affordable? >> let me start with the affordability. thell talk about both from state-based exchange -- >> i have two minutes and 46 seconds. do you have a plan to get the young people back? >> yes, we do.
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roll out that plan. our goal is to stabilize the website this month, and then we do have a targeted plan that includes not only young people, but the large populations of the uninsured in markets. so yes, there is a plan. >> what kind of plan is it? >> it is a combination of media, both television, radio, some print. it is identified by top markets, and i'm happy to share that plan with you all. >> and do you think you will restore confidence in this plan? >> yes. >> how? >> first of all, by improvements in the website, which we are already seeing. and i would -- encourage folks if they have not been on the days,e in the last few please go on. we are seeing improved applications and getting more positive feedback from individuals. there is a terminus amount of interest in this plan. like i said, there are's -- a tremendous amount of interest in
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this plan. like i said, there are over 700,000 applications. we have received over 13 million visitors to the website. the information is out there. >> i would like to go to go into the website, which also gets to constituents.ral we talk about the washington corridor, but not everybody has access to the computer and not everybody knows how to use a computer, including young people. we worry in maryland about the digital divide. governor o'malley, ben cardin, mybara mikulski -- but question is, you can go to the .hone are you publicizing this number? number two, if you want a paper application, or you want to be able to talk to someone in doson, as you said, where you go and where do you get this? and other designated sites? other words, will we do this
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in post offices, libraries? do thise we going to where people can actually be able to do this if they are not going to go to a computer or a computer is not available or their friend? >> that is a great question. we do advertise the 1-800 number. you candvertise that call there to get information if you don't want to use the computer. we also advertise where in the community. over 70,000 brokers have been trained to assist people. have navigators in every state. they are covering the entire state. we advertise that. we have hospitals and other associations, including libraries, who have been certified and are offering to help. >> i'm going to be blunt, because i really want this to be a success. and my job is to pinpoint solutions, not finger point looking in a retro way. i think it is very confusing.
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i know my time is up, but i think it is very confusing about where to go. we hear about the navigators and this and that, but i can tell you people really do not know. they really, really don't know. >> senator isaacson. >> inc. you, mr. chairman. administrator tavener, thank you for coming today. two fsi 10 days ago the was put in charge of coordinating the website and the hub, is that right? were you aware in june of this year, the inspector general issued the following report on two ssi that said quality software services incorporated did not sufficiently meet security controls over usb ports and devices, thus risking control issues over the information of medicare and
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medicaid beneficiaries? were you aware of that? >> no, sir. >> i would like to put in the record the report from june. they expose over 6 million been a fairy -- beneficiaries of 's information. i try to check everything out, but this morning, it seemed to be a pretty -- pretty credible claim that a lawyer in south carolina had gone on the website and gotten access and set up an account and was called by a man from north carolina that when he put in his password, he got that man's information. security istion extremely important. mike rogers in the house has made some pretty strong statement about the importance of keeping it secure. i would ask that you follow the ig's report and make sure that qssi is in compliance, and if they are not, that they get into compliance. >> i will follow that up with
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two things. we have a contractor doing security at the market place and we are working closely with them. this incident in south carolina, we were made aware of that yesterday and we implemented a software fix yesterday to fix that. as awill be treated personal identification issue and we will do a complete follow-up on that. >> you said in your testimony that is going to be ongoing, because we all know cybersecurity is an ongoing challenge. but i think it is an -- it is critical to tell the person in andge to deal with qssi make sure they get into compliance. >> i will make sure. like secondly, as one who is was an independent contractor for 33 years and had about 1000 contractors working for me, most of the people were uninsured -- who are uninsured or have lack of good insurance are contractors. but the unintended consequence -- yesterday, i was with a group
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of them in atlanta speaking to them not about health care, but i had three of them come up to me will stop mrs. russell, who had her own insurance that she me.bought -- had come up to mrs. russell, who had bought her own insurance and had received a cancellation notice. she called the toll-free number and had gotten help from a human being that said they would send the information, but could not guarantee when it would come. but what is this, when we passed the affordable care act, it precluded insurance agents from being the navigators and putting a medical loss rate so high that -- the onlyt be incentive to tell somebody what is in the plan is to go to the a navigator. i think that you should rethink the prohibitions on the medical loss ratio and an intended consequence of not allowing health insurance agents to be navigators. that is limiting access to the and limitingle
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information you want them to have. that is my editorial comment. by last question, would you put up the chart? of george ands things of atlanta. but there's a lot more to it and a lot of the state is very rural . in southwest georgia, today, the premiums are doubling, more than doubling in many cases. and health insurance costs are going through the roof. when you said that website was only the tip of the hyper dash iceberg, you are right, because you're a tremendous challenges -- the website was only the tip of the iceberg, you are right because there are tremendous challenges. on behalf of the georgians in my stay, we are seeing a doubling of their premiums will stop we need to address that and make sure that the unintended consequences of requiring so much coverage is not running people out of coverage, rather than providing them the coverage they need. do you know what is contributing to the cost of rural health care
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going up so much in terms of the premiums? >> i would not be the expert there, but obviously, the more competition we have, it tends to lower prices. i find rural areas -- i'm not familiar with georgia, but i am with virginia, and that was part of the problem. it was not enough competition and the rates tended to be high. the rates were higher prior to the limitation of the affordable care act. we have seen new entrants into in most all states. we are hoping that these will continue to press the pricing downward, because competition does help. >> thank you. my time is up. >> senator murray. chairman, an mr. administrator tavener for being here and all the work you are putting into this. when we passed before the care act, we designed it to have states lead away and draw up market reforms by building their own marketplaces.
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states like kentucky and my home state of washington land and designed and created their own marketplaces. of course, many states declined the opportunity to build their own marketplace and relied on the federal government to do their work for them. washington state has been a national leader on the launch of their new marketplaces, and in and rolledonth, nearly 55,000 people from my state for new health insurance coverage, including 10,000 kids. i am proud of the work that is being done in my state to provide access to quality and affordable coverage. i want to ask you to tell us a little bit about what you are seeing in the states like mine that develop their own marketplaces. >> you certainly listed some of the top. i will just list a few. all of the states are working hard. we have 17 partners at the state level, including d.c. i would say that what we are seeing in washington and oftucky are probably some
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the strongest performance. which is great. there is lots of application interest. the other areas that i would say because of the size of the state are new york and california where we are seeing good progress. each of the states are moving along, and part of what we will be submitting in november, as i have talked about in previous hearings, is information about applications and enrollments that will look at the state and what is inside the state as well as the federal marketplace. we will have more data for you. >> good, we will be using some of those states to have as best practices. >> we meet with them regularly and we will be meeting thursday. >> i also wanted to ask you about the next roundabout reach to americans and what it will look like. everybody is focused a lot on the website. we all know it is improving. those issues will be solved. but obviously, a lot of americans are frustrated about
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their initial applications. gotten -- got to get them to return to the site. to those people, i want to know about the administration's plan to reach out to the americans who have individually purchased land and those are being canceled by their insurance companies. there was a story in our paper in seattle about a 56-year-old woman who received one of those cancellation notices, and who like a lot of other people, was told to blame the affordable care act in that letter. but of course, she was not told that if she accessed the aca marketplace, it could save her and her family thousands of dollars and provide her with upgraded, more comprehensive health care coverage. i thought that was an important reminder that it is going to be an uphill battle against some political and industry interests to get those individuals good information that have received
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those letters. i want to know what you are doing to get information out to those people whose policies have been canceled that we have been hearing about. >> this is a conversation we are having a today. we have a consumer assistance program within cms, and is there a way that we can actively engage people who have been canceled? although they have been canceled, they are offered another policy. it is important for them to understand it is not just that policy. it is also the ability to go on the exchange. as you mention in washington state, they do not even have to apply. they can look at what the rates are. we can now do that on the federal exchange as well. i will have to get back to you on that, but that is there as well. >> at is really important, because a lot of them are just being "your policy has been canceled by obamacare" and not being told what their options are.
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>> senator nz. >> i'm from a low population state. we are pretty much world. -- rural. and we recognize that the problems with the website or probably just the tip of the iceberg, much as this chart demonstrates here. saturday, 20 people in wyoming had the policies canceled. ago, itely, three years noticed that the rules were changing and that people would not be able to keep what they had been robust. we have a method -- what they had been promised. we have a congressional review act and i petitioned and we had a debate about repealing the rule that would have kept them from keeping the policy that they like. i was voted down on straight party lines. willnk some people probably be paying for that in
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the next election. i am the accountant, so i will go into more of the technical questions with this website. it is my understanding that the cgi contract is a cost plus contract where the company will continue to be paid for its work while they try to straighten out problems that maybe they even caused. how much more will it cost to fix the website, and where will these funds come from? also, if it is their fault for delivering a product that did not meet doesn't -- specifications, do you intend to recover payments for them? >> you are correct, the cgi contract is a cost plus contract. first, there is not additional funding being provided to cgi. they will work and make these repairs within the existing contract. regularly with not only cgi federal, but also cgi global , to have these conversations,
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including one at 8:30 a.m. this morning. the work is expected to be completed. there are recovery processes, even in a cost plus contract. i will have to get you that information. i would not want to rely on my brain for that one. but i will work with our contracting person. but i would like to be able to get a copy of the contract as well. -- >> i would like to be able to get a copy of the contract as well. is there one with qs as well? si is that a cost plus contract as well? >> i will have to get you the details on that. i can certainly get you the information you requested. >> where is cgi headquartered? >> the headquarters are in virginia will stop -- in virginia. >> and qssi? >> that is a good question.
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minnesota? i'm guessing on that one. they also have offices in virginia. we are working with both the national and local. >> i also serve on the finance committee, and in the finance committee, cms testified on doing the testing on this website. we were assured that it had all been done. it is my understanding there was testing still going on the day before the website opened and that there had not been the security testing that either was called for or was not called for. how much security testing was done as part of the data testing? >> this is what i was trying to explain earlier. there are two components to the federal exchange. one is the hub, and that was completely tested, security


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